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Can Technology Fix the Health Care System? 570

Posted by samzenpus
from the here-is-your-digital-liver dept.
I was surfing through my usual tech sites for the latest news when I came across an article on Wired News. It turns out Steve Case is not alone in the quest to fix the health care system. I guess I don't get what the big attraction for these guys are.... I know the US's health care system is messed up, but I'm not sure technology can fix all of the aches, pains and dysfunction in our current system. I don't get why they don't just join a major company's board or start a hip/trendy start-up....
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Can Technology Fix the Health Care System?

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  • The biggest impediment to a great health care system is, and will always be, regulation. Regulation comes from one monster: the State.

    The US had the greatest healthcare system in the world. Then the U.S. Federal State decided to start destroying it, piece by piece, through regulation. After the HMO Act of 1973, healthcare quickly degraded. Instead of removing the regulations, the State decided to make new ones, creating more aggressive monopoly powers (see: AMA), making costs go up (by providing tax rel
    • by belgar (254293) on Wednesday May 02, 2007 @07:43PM (#18965201) Homepage
      Those who care only for themselves, and have no consideration for the world around them, depress me.
       
      Sometimes we pay to help those who need it. That's the way a community functions. As a Canadian, while I maybe don't have the health care that I need the instant I need it, it's still pretty damn good -- especially when there's an emergency. I pay for it, but I also live in a healthier society as a whole. Perhaps if you had better national helath care, you'd have fewer working poor, who can't afford health care, but make too much for subsidy, and get caught in the nightmare treadmill of constant debt because of a trip to the hospital.
       
      Libertarians make me sad.
      • by bheer (633842) <rbheer AT gmail DOT com> on Wednesday May 02, 2007 @08:08PM (#18965445)
        > Libertarians make me sad.

        As a libertarian, I must say that as long as your hand is out of my pocket, I don't give a flying frak about how happy or sad you are.

      • by Prysorra (1040518) on Wednesday May 02, 2007 @08:08PM (#18965455)
        Why is it whenever someone blasts the negative role of government control, somebody has to remark about the person being "cold" or "indifferent" to the poor? Where did he say that the unfortunate should be left to die? He didn't, did he? Are some people seriously this programmed to believe that giving the State control is automatically more humane? If there is a solution more efficient and more effective than the State, then that is what should be.
        • by Copid (137416) on Wednesday May 02, 2007 @08:31PM (#18965717)

          Why is it whenever someone blasts the negative role of government control, somebody has to remark about the person being "cold" or "indifferent" to the poor? Where did he say that the unfortunate should be left to die? He didn't, did he?
          Well, when somebody advocates taking the state out of the picture without a proposal for replacing benefit that the state provides (e.g. making sure that people get basic health care, even when they have no money), it's not totally out of line to infer that they believe that doing away with that benefit is no big deal. "Get the government out of health care" is all good and fine, but the question remains, how do we keep people with no money from being left to die? If I see a proposal that answers that question while fixing the broken half-assed market that is our health care system, I'll start taking it seriously. Until then, we're just waxing nostalgic about how great it would be if everything was more like a Charles Dickens novel again.
      • exactly (Score:5, Insightful)

        by circletimessquare (444983) <circletimessquare&gmail,com> on Wednesday May 02, 2007 @08:20PM (#18965605) Homepage Journal
        libertarianism is nothing but a code word for selfishness, dressed up in political signals and philosphical portents. but if you dress up a cheap whore in a fine dress, she's still a cheap whore. so it is with libertarians and anyone who spouts that nonsense

        i put it this way: human nature is both altruistic and selfish. any political philosophy you present to the world has to address both sides of this coin, or you have built a political philosophy which is a nonstarter in the real world, because it doesn't jive with the nature of the humans you are attempting to impose it on

        we all understand why communism doesn't work: it depends upon altruism, and doesn't address human selfishness. in a communist system, selfishness still exists, in the human beings in the system, but unaddressed by the system imposed upon them, and so selfishness eats communism apart from the inside

        if you will, if a whole country suddenly went libertarian, you'd have the exact same problems as a communist country, in reverse along the axis of human selfishness-altruism. it would fail. as miserably and as surely as communism did. for the same reasons, in mirror image reverse

        libertarianism appeals to earnest but naive college students with too many philosophy books under their belt, but without any real life experience, who build castles in the sky in their minds about how the world should or would or could work if people just started behaving in ways people have never behaved in any culture or time period since the dawn of mankind

        it also appeals to rural folk, who don't understand how they fit into the larger world, and firmly believe themselves to be islands completely owing nothing to anyone else. what they are of course is coccooned within a larger country and system upon which the relative peace and quiet of their worlds depend. but it is hard to see that from the hinterlands until madness marches across the countryside, which it does, unfortunately, in societies that have abandoned the simple common human responsibility we have to take care of each other

        and it appeals to 40 something selfish assholes behind on their alimony payments, corrupt and personally bankrupt about any give and take in their lives. nothing more needs to be said of such people. we understand them, and we understand why libertarianism appeals to them on a deep level

        libertarianism is a gem of modern foolishness, and you are a glorious fool if you swallow the pap called libertarianism
      • I used to tell a very conservative friend, that if you create two areas, one which is liberal and has social programs and the other that is conservative and independent, people would choose to live in the first. We'd also have all the woman, which would be a nice addition.

        The problems with healthcare, IMHO, really reflect a capitalistic, market oriented economy. We have excellent healthcare in terms of keeping us alive when we're nearly dead, but little that makes the time we're here better. most of those t
    • Re: (Score:3, Insightful)

      by daeg (828071)
      MANY small clinics are switching to cash-only. Insurance? They don't care. Submitting insurance is incredibly expensive for small clinics. It requires many man hours of work. It requires computers, extensive records (above and beyond reasonable record keeping), etc. If you want your insurance to pay for it, you have to file it yourself, and hope you filed all the paperwork correctly, on time, with the correct proof and records.
    • by roscivs (923777) on Wednesday May 02, 2007 @08:03PM (#18965397) Homepage
      The US healthcare system has two choices to get better: either socialist free health care, or divorcing health insurance from employment. Right now we have the worst of both worlds. If people were free to shop around for health insurance like they shop around for car insurance, I'm confident that a host of problems currently plaguing our health care system would be solved.

      Unfortunately, although I think government regulation may well have been the cause of employment and health insurance being conflated, I don't think that deregulation will successfully disentangle the two.
      • socialist free health care"

        Do you mean "free" as in beer, speech, or taxpayer subsidized?

        Don't you realize it's easier for the government to control you when you can't distinguish between free and subsidized?

    • by Holmwood (899130) on Wednesday May 02, 2007 @08:19PM (#18965587)
      I've spent most of my life living under socialized health care systems. (Canada, Europe).

      These are very good for routine situations when the population is very healthy and the society (and hence government) is wealthy. They are ok for catastrophic situations when everything is well-funded.

      They are, I grant, dreadful in other circumstances.

      That said, the idea that 'federal regulation' is the only problem with US healthcare is decidedly simplistic -- with respect to the parent.

      To simply pick one problem that doesn't have an easy left/right solution -- lawsuits (and threat of same) are a serious problem in the US. Legal compliance costs and malpractice insurance eat up a huge percentage of a good physician's income.

      You want to ban lawsuits against physicians? Very bad idea for obvious reasons.

      And yet looking at political manipulation of the health care situation: right-wing protection of drug patents MAY drive innovation, but definitely drives up drug costs. Left-wing protection of trial lawyers drives up the cost of certain procedures and the practice of medically irrational procedures (e.g. C-sections), though it in turn MAY protect some people.

      On simple public health grounds a purely freemarket solution seems imprudent (consider what a pay for treatment approach would do to a poor person with some contagious plague?).

      Yet the statists don't have it right either. All I can say is that this area merits considerable thought and care.
      • The rest of the country is moving away from lawsuits, and moving towards binding arbitration? Create a legally mandated review and report system, and Doctors who are statistically out of whack get reviewed and if it keeps up, lose their license. Those hurt by incompetants should have a scientifically valid avenue for complaining and receiving restitution. However, the current system is busted.

        Current system, we do not award damages based upon merit, but based upon jury awards. While jury awards are a re
    • by easyfrag (210329)
      What's the old adage about insurance? Invite all your friends to dinner, and most will have burgers instead of steak. Agree to split the bill equally, and a few will order steak, but pay less for their share. Eventually, everyone will want steak, and they'll wonder why no one can afford dinner. It is no different with State-forced health care, and State-regulated healthcare.

      Give me a break. Health care is not the same as other "products". I can arrange an appointment to get a lower G.I.exam [deaconess.com] done for free
    • by IdleTime (561841)
      Unfortunately, the rest of the world disagrees with you.

      USA is spending TWICE as much per capita as countries with health care and still can not provide health care for every citizen.

      There is nothing wrong with national health care for everyone, just with the US system. It's a sad proof of failure when you spend more and get much less, even compared to countries with higher cost than USA.
    • by garylian (870843)
      It's too bad you don't really understand all the problems with healthcare. Try working in the industry, and you really begin to see the problems.

      Yes, there is too much government in healthcare. And HMOs were a good idea that went bad very quickly. But look at the real factors in the rising health care costs:

      A liability cap for negligence medical cases. Gross negligence shouldn't have a liability cap. Negligence, in legal terms, means you made an honest mistake, and is fairly easy to prove when it actua
  • by catbutt (469582) on Wednesday May 02, 2007 @07:37PM (#18965163)
    But I'd suggest that proper application of game theory is key. Making a system that is hard to manipulate (i.e."game") is a very challenging problem, and frankly, I find it a lot more interesting one than the submitter seems to.
    • People can't even seem to accept that that applies to politics. Healthcare is even harder to get people to listen to policy suggestions about.

    • by nbert (785663)
      Agreed.

      But I personally don't believe that there will ever be a system immune to betrayal. I've grown up in a country where almost everyone is insured (by legislation) and the health system works properly. The downside is that medical treatment is extremely expensive and those receiving treatment don't really care about it (since they don't directly pay for the cost they cause). This system works quite well as long as there is a reasonable amount of doctors offering service and as long as those treating peo
      • Re: (Score:3, Insightful)

        by catbutt (469582)

        But I personally don't believe that there will ever be a system immune to betrayal.

        Immune? Probably not. The point is to make it better than the current one.

        Slashdot's moderation system is good example of system that is difficult to game. Not impossible, but difficult. People will complain about it as well, but I'd like to see what people would think if Slashdot turned it off for a day and went back to "anything goes".

        Comparitively, making healthcare hard to game is a problem of immense complexity. Doesn't mean it can't be addressed.

        In my opinion it's outright impossible to find a reasonable tradeoff between health, profit and cost in such a system.

        Are you suggesting that the current system

    • Yet again we have a case where a system is broken for the citizens, but working just fine for the practitioners. Another system that is siliarly broken is the patent system.

      Sure, there are theoretically ways that these systems could be fixed, but in practice that would be very difficult to do.

      Why? The people who have the positions and power to make the changes are benefitting from how the status quo, so why would they really want a change?

      Healthcare workers get huge salaries, http://swz.salary.com/salarywiz [salary.com]

  • by TheNarrator (200498) on Wednesday May 02, 2007 @07:41PM (#18965189)
    If you took the current medical system and had the government spent 10x as much on it prices would rise around 10 times. That's because doctors who want to work are all working, getting paid very well, and more money will just make them have to raise their prices or, if their prices were fixed, result in a shortage of available time slots for patients. The fix is is to make health care more efficient by not requiring someone who had to go to 8 years of college to give you a refill on your antibiotics, etc. There are serious medical cases that need expert attention but the vast majority of health care problems suck up the efforts of lots of highly trained accountants, overseers, inspectors, lawyers, claims adjusters and health professionals when the transaction could be so much simpler if they'd just trust people to have a bit more personal responsibility over their own health and not try to make sure that every single step of their treatment is authorized and approved by a limited pool of highly skilled professionals who are much better employed elsewhere.
    • Bingo! (Score:3, Insightful)

      by swb (14022)
      You got it right. The doctors have established what amounts to a state-sponsored cartel that prevents anyone from practicing medicine who isn't a member of their cartel, even well-trained people like nurses or patients themselves who may be much better in tune with their health than they're given credit for.

      Oddly enough, one part of the "health care" system that's ignored is the war on drugs. I include it since its ostensible mission is the public health goal of preventing addiction and substance abuse.
  • It seems to me that the problem is expectations. If we set the bar lower, say providing 2001's level of capability, the costs for care would go down. Standard behavior with any product - cost of production for the original item goes down as time goes on (and patents expire, etc).

    However, whenever new technology in healthcare is unveiled, everyone expects that it should be available (new treatments, drugs, etc). Healthcare costs more now because more of it is available. There has to be a balance, and
  • by gweihir (88907) on Wednesday May 02, 2007 @07:47PM (#18965245)
    ... and a strong believe in suvival of the fittest. Look to Europe: Afordable, reasonable healthcare for everyone is not a dream. Many countries have it. For example in Swizerland everybody has health-insurance, you cannot be without it, whether you have money or not.

    However it is not possible with a free market, since that will charge customers whatever they still can pay and will let those that cannot pay die or live with problems that could be fixed. At the same time, hugely expensive treatments will be available for those that have the money and single wealthy individuals will be saved instead of hundreds without money. Face it: Despite its lip service to christian values, the US is one of the coldest, inhumane countries on this planet, were cristian values are preached but not practised at all. Instead there is this believe that the market can fix anything. It cannot were infrastructure questions like education, public transportation, healthcare, etc. are concerned, since all of these need a really long-term perspective and the will to make thinks work well instead of turning a profit.
    • Re: (Score:2, Insightful)

      by Mr. Flibble (12943)

      However it is not possible with a free market, since that will charge customers whatever they still can pay and will let those that cannot pay die or live with problems that could be fixed. At the same time, hugely expensive treatments will be available for those that have the money and single wealthy individuals will be saved instead of hundreds without money.

      Health care in the US is not free market, it is heavily regulated. Because of these regulations, the costs of health care in the US are IIRC, 2.5 tim

      • it's the inflation and beurocratic burden that is private insurance. This is the same thing that happened with auto repair.

        So yeah. remove greedy insurance companies, socialize healthcare, profit.
      • Because of these regulations, the costs of health care in the US are IIRC, 2.5 times higher than anywhere else in the world.
        Ah, the good old correlation == causation logic.
      • Health care in the US is not free market, it is heavily regulated. Because of these regulations, the costs of health care in the US are IIRC, 2.5 times higher than anywhere else in the world. Health care costs the most in the US out of anywhere in the world, and the US spends the most out of any country on health care, but does not get the benefits of those costs. So, a true free market system would actually be better than what is currently in place, because competition would allow a decrease in prices for
    • Re: (Score:3, Insightful)

      by cdrguru (88047)
      Europe generally has a quite different attitude towards death and dying than folks in the US. If you are going to die, just hurry up and get it over with. Whereas in the US it is something to be put off as long as possible, even by extraordinary means.

      Until you can convince folks in the US that they just need to shut up and die with dignity, there are going to be serious differences between European and US healthcare.
      • by gweihir (88907)
        Europe generally has a quite different attitude towards death and dying than folks in the US. If you are going to die, just hurry up and get it over with. Whereas in the US it is something to be put off as long as possible, even by extraordinary means.

        Until you can convince folks in the US that they just need to shut up and die with dignity, there are going to be serious differences between European and US healthcare.


        Well, yes. That certainly drives cost. By estension it improoves the income of the transfer
    • by malsdavis (542216) on Wednesday May 02, 2007 @08:18PM (#18965561)
      The USA will never have European style universal free health-care while the large pharmaceutical companies hold so much power. Currently pharmaceutical companies from all over the world love the USA as they can pretty much charge whatever they want.

      In European countries, national health systems buy drugs in bulk and so are able to leverage massive price-cuts which the pharmaceutical companies - who know they could risk loosing an entire national market - usually agree to.

      It seems pretty obvious to me that the reason for this situation is that here, unlike in the European countries, the pharmaceutical companies here give large campaign donations to both major political parties and consequently successive governments (from both sides) then give pharmaceutical companies a blank cheque to rip everyone off.
  • by Anonymous Coward on Wednesday May 02, 2007 @07:49PM (#18965259)
    A collar that shocks it's wearer every time they try to stuff a Big Mac, Twinkee, Slurpee or Hoagie down their gullet.
  • If tech is the answer, the initial attempts aren't going so well:
    http://it.slashdot.org/article.pl?sid=07/04/27/122 9244 [slashdot.org]
  • by esconsult1 (203878) on Wednesday May 02, 2007 @07:57PM (#18965329) Homepage Journal
    I mean, come on. People just want a pill to fix their woes. How many times have you met someone that you know have a condition that can be easily fixed through diet and exercise alone?

    Besides cancers and other similar conditions, most problems facing the health care industry are caused by lack of exercise and eating the wrong kinds of food, and its a hard thing for people to change. And generally health care professionals are afraid to give definitive health advice because of the opportunity of lawsuits. How many times have doctors told patients that they should "reduce" instead of "eliminate" or "substitute" some offending substance?

    There tons of evidence that most medications (some help) have horrendous side effects [medications.com] and yet people continue taking them as if there's no tomorrow. I think that no matter what doctors, tech, or the government does, its gonna take a sea change for Americans to wake up and smell the coffee and start taking their own health in their hands.
    • by scottnews (237707)
      Yep, Tech is just a tool and computers are dumb. They do exactly what you tell them to. Without a clear plan/vision all the tools in the world will not help.
  • Technology doesn't "fix" anything by itself.
  • by bcrowell (177657) on Wednesday May 02, 2007 @08:00PM (#18965365) Homepage

    Huh? I don't get it. How is technology going to fix anything? Sure, it's true that there are inefficiencies in the system, like being asked for your health history over and over, as described in the article, but you're not going to wring any major change out of this dysfunctional system just by digitizing people's health histories.

    Technology is part of the problem. Technology costs money, and part of the problem with the US system is that it encourages people to spend inappropriately large amounts of money.

    The fundamental problem is that it's a positive feedback system that's doing what positive feedback systems always do: wig out exponentially. If you really want to see something scary, look at an itemized hospital bill that includes the costs of things like bandages. The bandages cost 10 or 100 times more than they would at the drugstore. The reason they cost so much is that insurance companies are willing to pay it. Why are insurance companies willing to pay it? Because everything else is ridiculously expensive too, and anyway the insurance companies can raise their rates to cover it. Once the insurance companies raise their rates, the health-industrial complex smells money, and raises their prices.

    If you like government regulation, one very simple, sensible thing to do would be for the government to penalize people who are affluent, but have a low deductible compared to their income. If my annual income is $150,000, then they should use tax incentives to browbeat me into not buying insurance that has a deductible any lower than, say, $40,000/year. That would make me treat all these expenditures like real money, not like other people's money. All of a sudden I'd be complaining bitterly about the overpriced bandages. When a nurse pulled out one of the hospital's bandages, I'd say, "No no no-- wait, don't open that! My wife went and got some bandages from CVS. Here, use one of these."

  • Technology cannot. The system is broken from the implementation. I wish I had the reference material with me, but as explained in this TTC Course on Economics [teach12.com] the American system is set up to charge too much for services. The professor of those lectures recommends the German system over all other popular systems for being most efficient and manageable. He also suggests that the Canadian system is broken (which I use) but it is not currently as badly broken as the US system.

    Technology is not a solution for a
  • by TheNarrator (200498) on Wednesday May 02, 2007 @08:05PM (#18965409)
    I was in the emergency room for a few hours because I got suddenly very sick after a tooth extraction to the point that I was going to die. They ran a bunch of tests and gave me a saline iv and then sent me home shivering with a 102 fever.

    So I got the bill a few weeks later. It was astronomical. Luckily the insurance covered it but it was of course filled up with all kinds of obscure bizarre codes that only insurance billers know anything about. What I'd like to see is some auditor look very closely at how the money flows around the medical system and find the $3000 toilet seats that I'm sure are lurking somewhere in their. I wouldn't be surprised if there were a few dirty HMOs that were taking kickbacks from hospitals for over-billing. Hospital over-billing would also be a perfect way to launder money I'm sure because everybody expects the costs to be unreasonable.

    I think the best course of action would be for hospitals to sell their own insurance. Having the HMO and the hospital separate creates all kinds of incentives for fraud and over-billing not to mention many different sets of books to take care of.
    • by pete6677 (681676) on Wednesday May 02, 2007 @08:09PM (#18965457)
      The money doesn't go towards $3000 toilet seats. It goes towards $3000 worth of treatment given to an uninsured person, as the hospital is required by law to do. They make up for unfunded charity care by sticking it to anyone who has good insurance.
      • Re: (Score:3, Informative)

        by scottv67 (731709)
        t goes towards $3000 worth of treatment given to an uninsured person, as the hospital is required by law to do.

        Amen! Amen! I was wondering when someone was going to get around to posting the truth about how the insured pay for the services that are rendered to the uninsured. Health care organizations "give away" a certain percentage of their services to uninsured or under-insured patients every year. The fancy hospitals in the suburbs that generate a healthy profit are being used to support the hospi
      • Re: (Score:3, Informative)

        by Spectre (1685)
        You may not have noticed, but hospitals make far more off of the uninsured than they do off those who are insured.

        Look at an explanation of benefits for hospital treatment. If you have "good insurance", anywhere from 20-60% of the hospital bill is written off when insurance declares the amount charged to be higher than the industry established norm, then insurance pays their portion, and you pay whatever is left over. That "written off" portion neither you nor insurance pays for, the hospital just has to
    • I wouldn't be surprised if there were a few dirty HMOs that were taking kickbacks from hospitals for over-billing

      That's how HMOs work. Instead of kickbacks, they negotiate lower charges for participating medical organizations.

      I got Lyme Disease again last summer. I received a bill for $700 for a doctor's visit and several lab tests; my HMO paid $220, and the doctor's office was trying to get me to pay the difference. Not being a moron, I called my HMO, and they got me on a conference call with the docto

  • by cduffy (652) <charles+slashdot@dyfis.net> on Wednesday May 02, 2007 @08:06PM (#18965425)
    I'm senior tech staff at a late-stage startup making an EHR product (consider my bias declared), and I have a fairly decent window into at least a few of the places where the healthcare system is broken.
    • Overhead. Doctors need to hire transcriptionists and billing clerks to do work that could be largely automated. (Our product addresses this).
    • Ease-of-use. Most of the EHRs on the market require an office to switch to a very low patient load for a very long training period. This makes migration to a product intended to improve communications and efficiency into an extremely expensive and cumbersome proposition. (Our product addresses this).
    • Lack of communications (or standardized records formats). There are *some* standards (HL7 is what we use for integration with 3rd-party scheduling and billing systems where possible), but nothing widely accepted and comprehensive enough to be able to give a patient a flash drive with their complete medical history in a format any doctor's EHR product will understand. Worse, a lot of systems won't integrate with anything else without requiring the customer to fork out serious $$$ for the add-on functionality. (As just one small vendor, there's not so much we can do about this right now)
    There are a bunch of other benefits that EHR vendors try to sell folks on -- automatic warnings about allergies, ability to guide the physician towards checking for symptoms that could indicate a serious problem, etc etc etc; I'm coming at this from the back-office geek point of view, though, so I really have no idea how significant these are in the grander scheme of things.

    Is adding more expensive IT products magic fairy dust that'll make healthcare cheap? Of course not. But technology that's well-thought-out, well-implemented and sanely priced certainly can help to make healthcare less expensive -- and putting records in a portable format benefits everyone.

    (That said, there's a lot of poorly-implemented technology in healthcare... but that's a topic for a different, much more anonymous forum).
    • by cdrguru (88047)
      You mention giving a patient a flash drive with their records on it. How do you deal with patients modifying (or attempting to modify) the data?

      You know, they want to have some obscure disease and are sure they really do have it but there isn't any evidence to support them really having it. You hand them their records and when they give them to the new doctor, volia, they were being treated for disease X.

      There are also the drug-seekers. Somewhat different problem but still pretty much the same thing.

      Yes,
      • by cduffy (652)

        You mention giving a patient a flash drive with their records on it. How do you deal with patients modifying (or attempting to modify) the data?
        Digital signatures, of course.
  • by DebateG (1001165) on Wednesday May 02, 2007 @08:07PM (#18965435)
    My friend and I just had a conversation about this last night. The fundamental problem is that your health is my responsibility, no matter what.

    Let's say we went to a world where only private doctors existed and no one accepted insurance. The rich will be able to afford most care (although they're pretty much dead if they need something big like an organ transplant). With insurance so expensive these days, this isn't too far off from reality today.

    Now, pretend that you're poor, and you come down with melanoma, despite your best attempt to avoid the sun. You can't afford care, so you wait until the last minute to get care at the ER. By then, your disease is probably advanced and much more expensive to treat, and the ER can't turn your away legally.

    The ER charges you some really high price that you can't pay. They repossesses your car and foreclose on your home so you can pay for it. Maybe you can find a lawyer to declare bankruptcy. Meanwhile, the ER is still waiting for their payment, and the doctors have to be paid to pay off their student loans. So what do they do? They charge the rich people more to offset the cost.

    Now you're now homeless, without a car to get to work, unemployed, and you're still in debt. Where do you go? Perhaps you turn to a life of crime and end up in prison. You definitely end up on welfare and Medicaid, probably living in a homeless shelter that is likely funded by tax-payer money.

    This isn't some theoretical story. It happens to people all the time.

    So, all of you who are terrified of having your tax dollars pay for "socialized health care," you're really missing the point. You're paying for it already. You're paying it in your hospital bills as cost shifting. You're paying for it via Medicare and Medicaid. You're paying for it in the prison system (which is the new mental health system). You're paying for it in terms of treating STDs by county clinics and through federally-qualified health centers.

    Socialized health care is inevitable because it's already here, albeit in a horribly disorganized and inefficient state. If we kept everyone healthy, the cost of health care would drop for everyone. The question is, how can we do that while balancing quality care?
    • by umbrellasd (876984) on Wednesday May 02, 2007 @09:17PM (#18966211)
      By saying no to procedures that can save a person's life but entail too great a cost. It's exactly like having a budget. You have the money to buy that new car, but you look at your finances and say that you will do without. Only in this case, it's not a new car. It's a new heart, or an expensive cancer treatment.

      Now many people reading what I just said are probably thinking, "That's inhuman." These are people's lives, not cars. Well, I'm sorry but this is exactly why health care costs are spiraling out of control. Just like the United States being a debtor nation because people cannot say, "No."

      I worked in health care as an analyst and application developer for 3 years. For one: it's a nightmare to use technology to do anything because the systems are hugely complicated and entangled in an enormous amount of rules, regulations, qualifications, exceptions, and so on. For two: we have all the statistical information necessary to classify diseases and injuries by cost and come up with a budget that says, "We can treat that, but the cost is too great given the statistical occurrence of the problem, so we can not treat you."

      The outcry against that would be tremendous. But I can tell you for a fact that this is exactly what happens on a battlefield. Any battlefield: a corporate takeover, war between nations, etc. People make brutal choices that have a huge negative impact on peoples' lives all the time. A company buys another because it is expedient and then they let go of 50% of the workers. We don't like that, but we accept it.

      But if someone says to most people, "I'm sorry but we cannot treat 30% of these problems. We have the money on hand in the short-term, but in the long-term it will break the system for all of us." People are not altruistic. People will not accept the fact that they have cancer and are going to die because the treatment is available but too statistically expensive. People will not accept the fact that they need some expensive heart surgery because they have been pouring fat and sugar into their bodies for years and now it's time for someone to pay for that abuse.

      Many people don't take responsibility for themselves, because we don't have a system that requires it. We put people in prison and relieve them of the responsibility of food and shelter and making adult ethical choices. We provide expensive treatments for people that need emergency treatment because an emergency has occurred as a result of years of abusing themselves. And so on.

      We're not going to fix a damn thing until we get better at saying, "No" in the short-term when it is absolutely necessary for a sustainable long-term. And that's true in all aspects of society. Health care, the environment, economics, education, whatever. It's all the same single cause. Most people can't make personal short-term sacrifices for long-term gain. Debtor nation. The one's that can, don't spend much time talking about these things because it goes nowhere. They can't solve other people's problems. People need to take responsibility for themselves or the few that already do have to carry everyone else.

      • Umm, you're making it sound impossible to have decent health care that covers the basics. Most industrialized countries have done that, except the US, without resorting your "inhuman" suggestions.
        • Re: (Score:3, Insightful)

          by umbrellasd (876984)

          Progress can be made and health care for everyone is not impossible. But abuses of that system must be curtailed. An example of abuse is one individual consuming enough health care resources to provide a basic level of health care to 20 others because they have some rare disease (congenital or otherwise) or they treated their body poorly (drug use, obesity, etc.). Another abuse is any individual that is sitting on billions of dollars in wealth or is making hundreds of millions of dollars a year. There'

  • US medical system (Score:4, Interesting)

    by SimonInOz (579741) on Wednesday May 02, 2007 @08:08PM (#18965453)
    The US medical system is definitely sick. US citizens spend drastically more on medical care than other countries. If you are poor you cannot get decent medical help. If you are a visiting tourist and you get sick then you are in for bills that will make your eyes water.
    If you are in a job it HAS to pay medical insurance. People are terrified, not so much of losing their jobs, but losing their medical cover. (Yes, I do know that ruling a frightened people is much, much easier).

    Why?
    It isn't true in the UK, or Australia, or Europe. So it doesn't HAVE to be so.

    But then the USA is one of the most unbalanced countries on Earth. By unbalanced, I mean the rich-poor gap is horrendous. Here we have the richest country in the world, and yet it has large numbers of poor illiterates, sick and dying. It is very, very sad.

    I think it is amazing how the USA has gone from being perhaps the most admired country on the planet - say after the 2nd world war, to one of the least admired - say now - in barely a single generation. Quite an achievement.

    I think it's time the USA started doing things that the world could admire, instead of steadfastly serving its own interests. In the medium to long term, being greedy and acting like a spoilt, petulant child tends to result in nobody liking you.

    What could they (you) do?
    * clean up your own backyard
        * Institute a decent national medical system. Increase taxes to pay for it. Kill off the medical insurance companies, push back the tide of wealth in the medical profession
        * Fix the schools. Put money into the system (gosh, there's tax again) especially in the poor areas. You NEED those scientists and business folk who drive you economy - and if they don't get a decent education because they were born poor, black, Hispanic, Muslim, female (or any of the other sins of America), you won't get them
    * stop messing up the world. Stop starting wars (USA has started more than any other country since the 2nd world war ended). Try to do some good - but not with soldiers
    * start doing thing that need to be done. How about really, really investing in sensible power generation (and stop giving tax breaks to oil and coal companies - maybe that would save you some of the tax). Do some decent research. Put some people on the moon. Make the world proud! You've done it before - do it again

    Mind you, a good start would be just stop driving those horrible little trucks (called truck so they can break their own rules on fuel consumption - I mean really, guys).

    Sweden is a far easier country to admire. Finland ... The list is far too long, guys - you come below Ireland in the Human Development Index. It's about time to pull your socks up America.

    And getting a fair and equitable medical industry would be a good start.
    • Re: (Score:3, Interesting)

      by Mr. Flibble (12943)

      I think it is amazing how the USA has gone from being perhaps the most admired country on the planet - say after the 2nd world war, to one of the least admired - say now - in barely a single generation. Quite an achievement.

      Externally, looking in I agree with this statement. I think that the systemic problems in the US right now stem from the fact that the US has begun moving away from a free market system such as it was originally founded upon. The US has begun moving away from personal liberties upon whic

    • Re: (Score:2, Insightful)

      by goldspider (445116)
      Indeed, we need to start emulating socialist utopias like France. I'm tired of living in a fascist country where I have to work for my salary.
  • by Ngarrang (1023425) on Wednesday May 02, 2007 @08:12PM (#18965481) Journal
    I worked in a hospital for 9 years in the IT department. Trust me when I say that technology was NOT the impediment, but nurses and doctors who refused to use the technology. Instead of thinking about the positive uses (checking drug interactions, streamlining data collection, improved imaging times), the mere idea of "technology" was shunned by these supposedly-educated professionals.

    I will never work in a hospital ever again. It was too painful the first time around. I understand that not all users are going to be computer proficient, but to have a user BRAG how little they know about computers, and they will be retiring in a few years, so they will just drag their heals...

    Guh!

    If ever there was a time to justify beating something with an ethernet patch cord, that was the time.

    Fix the people and you fix the single largest impediment in any system.
  • The insurance industry is the reason the healthcare system is so screwed up.

    First, theyre greedy as all gtfo. Medical insurance rates have skyrocketed to the point even large corporations can't afford group rates, let alone individuals affording individual rates, and the boards which are supposed to be regulating them are sitting on their hands and taking kickbacks.

    Second, they're greedy as all gtfo. The function of insurance (just like the lending industry), is to spread risk among many people. Except t
    • by cdrguru (88047)
      Almost nobody in the US pays directly for health insurance. The number is way, way less than 20% of the population. So, yes, there would be significant restructuring in costs that would shift things around.

      Yes, you might get paid more and have to pay more taxes. It would eventually balance out, I'm sure - but not right away. Probably not for a long time.

      And most of the Clintonesque 40 million aren't going to be paying taxes either. So their "coverage" would be about the same as it is today. You go to
  • For the US healthcare system, technology has a huge role to play in improving things. Lots of low-hanging fruit, and an important mission given the state of things:

    - Efficiency. The inefficiency of paper is pretty obvious. Nuff said.

    - Record portability. Again, an obvious win to anyone who has been referred to see specialists and must complete a separate history for *each one*. Truly ridiculous.

    - Reduced error in prescriptions. Many people get multiple prescriptions from different doctors who aren't f
    • by cdrguru (88047)
      A significant problem with record portability is the amount of patient fraud that can be introduced. What doesn't your doctor want to give you a sheaf of paper to take to another doctor? Because you might decide to make changes.

      There are many reasons why people might do this. The obvious ones are things like you are convinced you have some disease. Your doctor doesn't agree. You get some of his letterhead and write a little note saying you do have it and take it to another doctor. If you might or migh
      • by schwaang (667808)
        Personally I'm much more concerned about your last point, privacy, than I am about possible fraud. Having been through cancer care for a family member, record portability would be such a win that it outweighs any fraud issues, IMHO. And actually I'd tend to think technology would help improve your letterhead scenario. (Records can be digitally signed, etc.)

        But preserving privacy is going to take some heavy lifting, especially if we want to enable organizations to share data. Centralized databases of any
      • by Artifakt (700173)
        I certainly believe it 'goes on plenty' in the current system. However, you're not really nailing the point, even though you came very close by mentioning Percodan. As you put it, there are many reasons why people might do this. What you cite as an obvious one is actually one of the very rare ones - effectively Munchausens direct and by proxy. What's common, really overwhelmingly so, is doing record tampering to get a fix or sell someone else a fix. By FBI estimates, 95% or more of medical records tampering
  • ..did this "journal" post make it to the front page of Slashdot? Looking at the day's posts, apparently there's no a damn thing interesting happening in the world of "geeks".

    And yes, I agree, our national health care system (hah) is non-existent and needs addressing. And there are plenty of discussions to be had among reasonable and intelligent people. But this post isn't the prod for that kind of conversation. It's half a thought, and literally ends on an ellipsis.
  • While Mr. Grove's suggestions are not terrible, they are attacking problems that are ancillary to the efficient operation of the health care system as a whole.

    The biggest problems in the US healthcare systems are of access and funding. Not everyone can afford access to basic healthcare, and those that can are - generally - paying too much for it. The first contention is sufficiently obvious that I won't bother supporting it. The second should be pretty clear if we look at the profits generated by health ins
  • The most significant problem with modern Western health care is not the technology per se, it's the inappropriate use of it. It's all too tempting for doctors to order more and more sophisticated tests whereas, in reality, "take an aspirin and see me in the morning" would do. It's great to have access to the latest, expensive, whiz-bang technology; but it the majority of cases it isn't appropriate, nor needed. There's a similar story for antibiotics - use these prophylactically and you eliminate the odd
  • by obeythefist (719316) on Wednesday May 02, 2007 @08:38PM (#18965803) Journal
    Seriously, if you were going to try to fix the health system, would you try to do it without use of technology?

    Without I/T systems and infrastructure, obviously any new system you implement to replace the older, obviously inefficient systems would be paper based.

    While paper based methods are necessary for some systems (see George W. Bush, US Elections for clarification), I cannot see that being applicable to health care.
  • Government regulations and meddling created the problem. What we need is a sliding scale system and allowing medical institutions to be tax-exempt.
  • I've spoken with people who worked on large-scale projects to create IT systems that would monitor patients, gather statistics for datamining (to improve the treatments and learn new correlations), and even automatically suggest diagnoses and drugs (with references and reasons for the suggestions) to help doctors save time. I know two separate groups who tried similar projects. Both projects failed for the same reason: Doctors did not want their actions to be logged. Doctors want the freedom to skirt pr
  • The problem (Score:3, Insightful)

    by Brandybuck (704397) on Wednesday May 02, 2007 @10:19PM (#18966867) Homepage Journal
    The problem isn't the technology. The US health care system has the best technology in the world. That's not what's broken. The dysfunction comes from removing the health care recipient (you and I) from the health care market.

    We don't buy health care, we buy insurance. While insurance works great for catastrophic needs, it falls flat when it comes to ordinary day to day needs, regardless of domain. Automobile insurance works because automobile accidents are (relatively) rare. But our costs are skyrocketing because we are using the insurance mechanism for day to day healthcare. It's as silly as buying food insurance to provide our groceries. The problem is further exacerbated because insurance companies are disinterested agents. They want to keep their costs down, but as long as we pay them, they have no interest whatsoever in keeping *our* costs down. The market system is working, but it's not working for us because we are not a part of it.

    This isn't about whether healthcare is funded by the government or not. We can have government funded healthcare in a market based system. We just need to get the patient back in the role of consumer. If you give the poor vouchers for healthcare, and then allow everyone to purchase their day to day health maintenance needs out of pocket, the system can get start getting back on track.
  • by cheros (223479) on Thursday May 03, 2007 @03:47AM (#18969233)
    You don't fix systems that large by throwing technology at it.

    Unless you fix the setup structurally so it's managed in a decent way instead of by deadbeats and get a consistent strategy and approach in place you'll be throwing money away as you're not fixing the real problem.

    The irony is that fixing the real problem would be a huge money saver as well - but that would stop several gravy trains at once, of course..

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